Diagnose Carpal Tunnel Syndrome Des Moines IA

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Dr.Steven Aviles
(515) 247-8400
411 Laurel St # 3300
Des Moines, IA
Gender
M
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
5.0, out of 5 based on 1, reviews.

Data Provided By:
Craig Robert Mahoney, MD
(515) 371-3230
411 Laurel St Ste 3300
Des Moines, IA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ia Coll Of Med, Iowa City Ia 52242
Graduation Year: 1995

Data Provided By:
Michael Lyle Campbell, MD
(520) 228-2522
3000 Grand Ave Apt 1015
Des Moines, IA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Med Univ Of Sc Coll Of Med, Charleston Sc 29425
Graduation Year: 1992

Data Provided By:
Joseph Ferdinand Galles, MD
411 Laurel St Ste 3300
Des Moines, IA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ia Coll Of Med, Iowa City Ia 52242
Graduation Year: 1993

Data Provided By:
Stephen Alan Ash, MD
(515) 247-8400
411 Laurel St Ste 3300
Des Moines, IA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ia Coll Of Med, Iowa City Ia 52242
Graduation Year: 1993

Data Provided By:
Michael Andrew Gainer, MD
(515) 247-8400
411 Laurel St Ste 3300
Des Moines, IA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Southern Il Univ Sch Of Med, Springfield Il 62794
Graduation Year: 1995

Data Provided By:
Marvin H Dubansky, MD FACS
(515) 247-8600
3660 Grand Ave
Des Moines, IA
Gender
Male
Education
Medical School: Iowa
Graduation Year: 1947

Data Provided By:
Timothy George Kenney, MD
(515) 247-8400
411 Laurel St Ste 3300
Des Moines, IA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ia Coll Of Med, Iowa City Ia 52242
Graduation Year: 1984
Hospital
Hospital: Mercy Med Ctr, Des Moines, Ia; Iowa Lutheran Hosp, Des Moines, Ia
Group Practice: Iowa Orthopaedic Ctr Pc; Mercy Medical Center Administration Office

Data Provided By:
Cassim Mohamed Igram, MD
(515) 247-8400
411 Laurel St Ste 3300
Des Moines, IA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ia Coll Of Med, Iowa City Ia 52242
Graduation Year: 1988

Data Provided By:
James Maurice Boler, MD
(518) 847-4616
1301 Penn Ave Ste 213
Des Moines, IA
Specialties
Orthopedics, Hand Surgery
Gender
Male
Education
Medical School: Univ Of Md Sch Of Med, Baltimore Md 21201
Graduation Year: 1995

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Best Way to Diagnose Carpal Tunnel Syndrome

Dr. Brent Graham at the Toronto Western Hospital (Canada) has been working on finding the best way to diagnose carpal tunnel syndrome (CTS). Currently, there isn't a clear consensus on the best clinical tests to use in making this diagnosis.

Carpal tunnel syndrome is a common problem affecting the hand and wrist. Symptoms begin when the median nerve gets squeezed inside the carpal tunnel of the wrist. Carpal tunnel syndrome is also known as nerve entrapment or compressive neuropathy. Any condition that decreases the size of the carpal tunnel or enlarges the tissues inside the tunnel can produce the symptoms of carpal tunnel syndrome.

In the past, Dr. Graham tested and validated a new clinical tool called the CTS-6. This instrument is a diagnostic scale for carpal tunnel syndrome. It includes six tests from the history and physical exam to estimate the likelihood that carpal tunnel syndrome is present. The CTS-6 has been tested and validated as a reliable instrument.

Now, in this study, Dr. Graham compared the results of the CTS-6 with electrodiagnostic testing. Electrodiagnostic testing consisted of sensory nerve conduction velocity (NCV). A segment of the median nerve was tested from the wrist to the middle finger.

There were several steps in this study. First, a hand therapist tested all new patients referred to the center for possible upper extremity peripheral nerve problem. The CTS-6 test was used to determine the pre-test chances the patient had carpal tunnel syndrome. Then these same patients were tested using a standard nerve conduction velocity test.

With the CTS-6 scale, each of the six items is given a point value. The six items include 1) numbness in the hand and fingers supplied by the median nerve, 2) muscle atrophy and/or weakness, 3) a positive Phalen test (standard clinical test used to diagnose carpal tunnel syndrome), 4) loss of two-point discrimination (feeling two separate points touched on the skin), 5) numbness at night that wakes the patient up, and 6) a positive Tinel sign (another standard clinical test used to diagnose carpal tunnel syndrome).

A total score of 12 or more suggests a strong probability (80 per cent chance) that the patient has carpal tunnel syndrome. A total score less than five indicates a very small chance (25 per cent) that the patient has carpal tunnel syndrome.

Comparing the results of the CTS-6 test with the results of the nerve conduction velocity test, the authors report the added information from the electrodiagnostic test was not enough to change the diagnosis or warrant the expense. A low probability of carpal tunnel syndrome (judged by the CTS-6) in a patient whose nerve conduction velocity was negative only lowered the chances of the diagnosis being carpal tunnel syndrome. There wasn't much value added by the electrodiagnostic test -- not enough to support the cost and discomfort to the patient.

With the availability of the CTS-6, there is much less...

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